NHS Update
Debate between Lord Dubs and Lord Bethell(3 years, 5 months ago)
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Lord Bethell (Con) [V]
My Lords, my noble friend hits the nail on the head. Not only is getting vaccinated and wearing a mask in the right settings a sign of support for NHS staff, it is a sign of support for the whole of society. We depend on each other during this pandemic. When someone catches the disease asymptomatically and spreads it to someone else, they hurt all of us. We all have to be careful to take our tests when we are going into a position of risk, to wear our masks when we are close together and, of course, now that the vaccine is available to all over 18 year-olds, to ensure that all the people we can persuade have taken two jabs.
Lord Dubs (Lab) [V]
My Lords, the Minister has on more than one occasion in the last few minutes been asked about the position of care workers. They have been totally left out of the pay settlement. They are working on extremely low wages. Does the Minister not agree that something must be done to help care workers, whether in domiciliary care or in care homes, to have a decent wage and not be treated as the country cousins in this whole thing?
Lord Bethell (Con) [V]
The noble Lord is right: we are concerned about the pay, conditions, career prospects and retention of care workers. I have spoken about this in detail in debates on social care, and I share the sentiments of the noble Lord. When we come to social care reform, the correct provisions for social care workers will form an intrinsic part of those reforms. I do not wish to be obtuse, but this is about the NHS. The NHS is a direct employment body, whereas social care has a different employment system and is therefore not covered by this particular settlement.
Covid-19: Care Homes
Debate between Lord Dubs and Lord Bethell(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, I am grateful for the tone of the question, but its assumption is, I am afraid, quite wrong. Before April 2020, there was very little evidence and no scientific consensus whatever that asymptomatic transmission posed any risk. For example, the World Health Organization said on 2 April:
“to date, there has been no documented asymptomatic transmission.”
My noble friend may remember that differently. They were very difficult times, and we made decisions on very limited information. We made the best decisions we could have done under the circumstances.
Lord Dubs (Lab) [V]
My Lords, as late as March last year there was clear evidence coming from Italy about people dying in nursing and care homes there. Surely if we had been half-awake we would have realised that what was happening in Italy was a solemn warning to us, and we should have acted accordingly. Why did we not do so?
Carers: Support
Debate between Lord Dubs and Lord Bethell(3 years, 6 months ago)
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Lord Bethell (Con)
The noble Lord puts it very well. Breaks are key. Some 6.5 million carers work flat out throughout the year. It makes all the difference to them if they can have moments of respite when they can lift their heads, conduct their usual tasks and get a little mental clarity. We are very focused on this issue, but I am grateful to the noble Lord for raising it.
Lord Dubs (Lab) [V]
My Lords, I also join colleagues in paying tribute to the millions of unpaid carers. Even before the pandemic, they were keeping the whole system going. The Minister has paid tribute to their need for respite care. Can this be translated into something tangible? How many weeks respite care can an unpaid carer have? I know unpaid carers who are desperate to have just a small break from their 24/7 commitment and work. How much time should this be? Furthermore, local authorities are in desperate financial difficulties. Surely, there should be some help for them so that they can provide residential respite care and give unpaid carers the chance to continue.
Lord Bethell (Con)
My Lords, I cannot provide a direct answer to the noble Lord’s reasonably broad question, which illustrates the very wide range of care undertaken by Britain’s unpaid carers. As the noble Lord rightly says, some are working 24/7, almost without respite, in incredibly demanding and challenging circumstances, others are dropping in to see a neighbour for an hour or two a day, and there are many permutations in between. It is really important to have local provision so that there is tailor-made support by people who are close and in the community. I am afraid there are not the kind of blanket measures that the noble Lord seeks, which is why we work through charities and local authorities to provide the support that people need.
Covid-19 Update
Debate between Lord Dubs and Lord Bethell(3 years, 9 months ago)
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Lord Bethell (Con)
My Lords, I completely acknowledge the concerns of my noble friends Lord Dobbs and Lord Cormack about nosocomial infection. Undoubtedly, infections caught onsite in Britain last year and this year, and in every epidemic, are not only among the saddest forms of contagion but among the most dangerous. I want to reassure both my noble friends that we are absolutely focused on this point. It is, though, too early to make a call on professional mandatory vaccination. We have got through only the first 20 million people in the highest-risk and, therefore, the oldest age groups, and we have not moved through all the other age groups. The Cabinet Office is looking at this matter and has a review process in place. When that process has coughed up its findings, we will be in a position to debate the matter, and I look forward to that in due course.
Lord Dubs (Lab) [V]
My Lords, does the Minister agree that the success of the NHS vaccination programme is a tribute to the efficiency and success of the public sector, in contrast to some of the private organisations involved in other aspects of dealing with the pandemic? I want to put a specific question to the Minister. He used the phrase, “Until we are through this pandemic”. Would it not be more sensible to say that we may never be fully through this pandemic, so our planning must be based on the fact that we will have to continue with the vaccination programme as new mutations develop for many years to come? Would it not be better to look that far ahead?
Lord Bethell (Con)
My Lords, I disagree completely with the noble Lord’s first point. The vaccine would not have happened without AstraZeneca and the other private companies that have produced, manufactured and delivered it, so I do not know where the public sector would have got its vaccines from. I completely reject that point.
I agree with his second point. I should not have said, “When we are through this pandemic” because we are going to live with its consequences for many years to come, and if it is not this pandemic, there may be others in the future. We have all, I think, taken on board the fact that in the modern world, there is a new, 21st century cost for the kind of global lifestyle that we have got used to, and that is the international spread of viruses. We can, I think, win the battle, but we will have to adapt. Learning how to do that is the challenge of this year.
Covid-19 Update
Debate between Lord Dubs and Lord Bethell(3 years, 10 months ago)
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Lord Dubs (Lab) [V]
My Lords, I am sure that the Minister will be aware that domiciliary care workers are very vulnerable. They toddle around from person to person, they visit people’s homes, and the people whom they support are also vulnerable. Will the Minister ensure that domiciliary care workers are given the maximum protection, whether through vaccines or through other protective measures?
Secondly—I could not give the Minister notice of this because I only got the details a few minutes before we started—refugees are being held at the Napier Barracks in Folkstone. I am told that there are people there with Covid who are sleeping in the same dormitories as refugees who do not have Covid. There is very little medical support. Will the Minister, as a matter of urgency, have a look at this and see what can be done?
Lord Bethell (Con)
My Lords, we have done an enormous amount for those who have been working in domiciliary care. The noble Lord is entirely right to shine a spotlight on those who play such an important role in the community, caring for the elderly and the infirm. The amount of itinerant travel, where these workers move from one person to another, has been dramatically reduced—partly to reduce the fear of infection. PPE has been used and we are putting testing in place for those working in domiciliary care. I am extremely pleased to report that this has had a huge impact on infection rates, and we will ensure that they are prioritised in the vaccine rollout accordingly.
I did not get the full details of the particular issue raised by the noble Lord in his second question, but if he would be kind enough to send me an email, I would be glad to look into it as he requested.
Covid-19 Update
Debate between Lord Dubs and Lord Bethell(4 years ago)
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Lord Dubs (Lab) [V]
I apologise. Does the Minister have any estimate of the number of people who are currently in self-isolation? Does he agree that if these people were to be given high priority for testing, their period of self-isolation would be shortened and more people would be willing to go into self-isolation because they would not lose so much money if they could be tested quickly and resume their ordinary lives?
Lord Bethell (Con)
The noble Lord hits the nail on the head. We have already brought into place a test-to-release programme for foreign visitors and we are looking at ways in which such a principle could be applied elsewhere.
Covid-19: South Yorkshire
Debate between Lord Dubs and Lord Bethell(4 years, 2 months ago)
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Lord Bethell (Con)
My Lords, grants will be available from 1 November, will be administered by local authorities and will remain in place until April 2021, with a review point in January. The funding will apply only to England and, if applied across the country, would provide over £250 million of support each month.
Lord Dubs (Lab) [V]
The Minister was asked about exit strategies from tier 3 or any of the tiers. He said that the answer was part art and part science. Will he assure us that that does not mean that when the Government do not feel like accepting science, they will simply be vague and ignore what the scientists say? He also referred to travel. Has he looked at the position at German airports, a point raised with him yesterday or the day before? Can we look again at checking people on arrival at airports? I know that one cannot be sure but checking on arrival and again a few days later would prevent the need for long periods of quarantine that are difficult for people to cope with. They may lose a lot of money and their jobs. Can we look again at this?
Lord Bethell (Con)
The noble Lord is right that the situation at airports is distressing and has caused huge damage to travel, the airline business and hotels. However, foreign travel represents a massive threat in forward transmission of the virus. Testing at airports catches only a tiny proportion of those infected, and quarantine arrangements are not wholly reliable. For that reason, we are running a pilot in the UK to see what can be done but we will tread cautiously.
Covid-19
Debate between Lord Dubs and Lord Bethell(4 years, 2 months ago)
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Lord Bethell (Con)
My noble friend illustrates the complexity of trying to work with local authorities and the impact of giving local authorities the discretion to make decisions on their own. In this area, in tier 3, we gave discretion to local authorities on their gyms. Merseyside decided to close its gyms and Lancashire did not. It is entirely appropriate for them to make their own assessment. I confess to feeling a real and genuine dilemma when it comes to gyms. My noble friend is entirely right that activity is important, particularly at a time of lockdown. However, medical advice on hygiene is that the spray from exertion and sweaty bodies is very difficult to contain, even in a well-meaning and well-managed gym. That is why we have given local authorities that choice and why we keep the matter under review.
Lord Dubs (Lab) [V]
My Lords, I have two brief questions. Somebody I know received the following message on their mobile phone:
“Possible COVID-19 exposure. Verifying exposure info. The app has accessed the date, duration and signal strength of this exposure.”
Can the Minister say what this means? Is the recipient supposed to do anything about it or is this some maverick message? My second question is on a different point. Does the Minister agree that there are people in this country who are too apprehensive about the possible quarantine to go abroad and so have to quarantine on their return to this country? Could we not adopt the system, which certainly seems to be working in Germany, that we offer testing for people arriving from areas where they are liable to be quarantined, possibly testing them two or three days later? That means they would not have to be in quarantine for two weeks and risk losing their job, and so on. Could we not adopt that simple expedient?
Lord Bethell (Con)
I reassure the noble Lord that his friend’s notification came from a new feature of Apple phones called “Exposure Notifications Express”. This is something that we have worked hard to incorporate in the existing app. I slightly suspect that, if she has a new version of the NHS app, she will not receive these notifications any more. We are grateful to Apple for enabling its phones to work in developing countries, but there has been some turbulence with our own app, which we think we have resolved.
On quarantines, I say that, as a follower of these debates, the noble Lord will know that the CMO’s view is that testing on arrival will capture only 7% of infections, and it is very difficult to apply quarantines to get people to commit to staying longer. However, we are committed to running pilots to try to open the kinds of schemes that he describes, and I would be happy to report back on their development.
Social Care Workers
Debate between Lord Dubs and Lord Bethell(4 years, 2 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, there is no doubt that we need more people to choose to work in social care. Prior to the pandemic, the vacancy rates for care workers in residential care and domiciliary care were 6.4% and 11.4% respectively. By June 2020, that had declined to an overall rate of 6.6%. We would like to see this number reduced further, which is why we are taking action to support recruitment nationally, and we expect local authorities to support care providers locally.
Lord Dubs (Lab) [V]
My Lords, yesterday the Prime Minister promised again to deal with the problem of social care. First, how will the Government fill these vacancies as a matter of urgency? Secondly, what priority will there be for social care in the Government’s digital and healthcare strategy?
Lord Bethell (Con)
My Lords, the immediate focus is on the national recruitment campaign across broadcast, digital and social media. We acknowledge that there needs to be more recruitment in social care. Encouragingly, the vacancy rate is down, from 7.8% to 6.6%, but we recognise that more needs to be done. We have launched the CARE brand to try to create a stronger employment brand around the care profession.
Covid-19 Update
Debate between Lord Dubs and Lord Bethell(4 years, 3 months ago)
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Lord Bethell (Con)
The noble Baroness absolutely speaks my language when she talks about the technology that is being brought into the front line. My sincere hope is that Covid will bring a benefit to the healthcare system by being an inflection point whereby we introduce new technologies in a whole host of fields to bring in much greater community-based treatment for people, digital technology and the more effective sharing of data, among a wide range of technical advances. Regarding the workforce, I completely sympathise with the noble Baroness’s comments. I pay tribute to those who work hard on the front line and am aware of the challenges and difficulties they face. This Government have committed to recruiting 50,000 more nurses. We are more than half way there already, and we will continue to recruit to ensure that we have the human resources needed to meet our commitments.
Lord Dubs (Lab) [V]
My Lords, what is the policy regarding the testing of domiciliary social care workers? What is being done to ensure that these people—who are at risk themselves and meet and support the very vulnerable, travelling around to different people every day—have full protective equipment and that they use it?
Lord Bethell (Con)
The noble Lord is entirely right to emphasise the challenge of itinerant domiciliary care. Such workers were always a vector for potential disease and are putting their own lives on the line. That is why we have radically changed the guidelines. We have put more resources in place to ensure greater support for domiciliary care, PPE is stocked for them to use and there is regular individual testing
Childhood Obesity
Debate between Lord Dubs and Lord Bethell(4 years, 3 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we published Tackling Obesity: Empowering Adults and Children to Live Healthier Lives on 27 July. The strategy demonstrates an overarching campaign to reduce obesity, takes forward actions from previous chapters of the childhood obesity plan and sets out measures to get the nation fit and healthy, protect against Covid-19 and protect the NHS.
Lord Dubs (Lab) [V]
My Lords, if the Government persist in abolishing Public Health England, who will be responsible for policies to tackle obesity? Secondly, does the Minister agree that tackling obesity, especially childhood obesity, requires more than a few policy headlines but rather a whole-government approach that includes healthcare, education, local government, transport, finance, the built environment, sports provision, advertising—especially social media—and scientific research, plus a focus on preschool children, disadvantaged groups and involving young people themselves?
Lord Bethell (Con)
My Lords, I pay tribute to those at Public Health England who brought together the obesity strategy announced in July and who will continue to work on the obesity strategy. We are consulting on where the ultimate home for that team should be. I emphasise that the obesity strategy launched in July was the most holistic and joined-up piece of policy on obesity in recent times. I emphasise that the money that has come from the sugar tax is now going to pay for sports in schools.
Social Care
Debate between Lord Dubs and Lord Bethell(4 years, 5 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we all agree that social care needs to be put on a sustainable footing where everyone is treated with dignity and respect. That is why the Prime Minister made clear commitments in the manifesto and the election, and why the Secretary of State wrote to other parties to begin the process of cross-party talks. We must now come together to find a common solution to this challenge: a long-term plan for social care that enjoys cross-party support.
Lord Dubs (Lab) [V]
My Lords, will the Minister confirm that the Prime Minister, said in his first speech in office that
“we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve … I will take personal responsibility for the change I want to see”?
Is that still the policy, or will the Prime Minister again claim that he has been misunderstood, as with his recent unpleasant attack on social care, for which he has refused to apologise?
Lord Bethell
My Lords, that is very much the policy, but I emphasise the following. No plan can succeed unless it gains the support of a wide number of stakeholders, including cross-party support. Attempts to foist a plan from one group on to another simply will not work. That is why a bridge-building exercise is needed and why the Secretary of State has invited others to cross-party talks. I invite all those players to go into that process with a spirit of collaboration.
Covid-19 Update
Debate between Lord Dubs and Lord Bethell(4 years, 5 months ago)
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Lord Dubs (Lab) [V]
We have frequently been told that the key figure to look at is the R figure. Will the Minister confirm that whereas after lockdown the national R figure was 0.84, it is now 0.94—so we are on a bit of a knife edge? Secondly, can he explain why the R figure is not released locally at the same time as the national figure is released?
Lord Bethell
The noble Lord is right that the R figure is important, but in many ways, at this stage of the epidemic, the prevalence figure—the total number of people who carry the disease—is more meaningful. A higher R on a smaller prevalence is less worrying than a smaller R on a higher prevalence. As to having regional Rs, the data to date has not been strong enough for that to be a reliable figure. However, we are working towards that situation and I can envisage a moment when it would happen.
Covid-19: Care Homes
Debate between Lord Dubs and Lord Bethell(4 years, 7 months ago)
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Lord Bethell
My noble friend Lady Blackwood is quite right that the Roche and Abbott antibody tests are a great step forward. It shows how diagnostic technology is progressing very quickly. We are determined to use all the benefits of modern technology in the fight against Covid. Our announcements on antibody testing in the NHS, in the care service and for key workers will be announced shortly. When it is, I assure her that NHS and social care workers will be on an equal footing.
Lord Dubs (Lab)
My Lords, in answer to an earlier question, the Minister said that it was not appropriate to compare us with what happened in Hong Kong, South Korea and Singapore, which had no deaths in care homes at all. He preferred to compare us with Europe. Is the truth not that we took our eye off the ball and that as a country we failed to learn from what was happening elsewhere? We failed to learn good practice and we actually lost two months, where we did nothing very much until we tried to catch up just now. Surely we failed pretty badly.
Lord Bethell
The noble Lord makes a comparison that history will have to judge on, I am afraid to say. I think that I am making a fair point when I say that Britain can really only benchmark itself against its close neighbours. The experience of Asian countries taught them an enormous amount, but it is not one that has seemed proximate or relevant to us in recent times. I am afraid that I can only leave it to history to judge whether we made mistakes. It would be wrong for me to prejudge that at this moment.